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(Hypertension. 2006;47:325.)
© 2006 American Heart Association, Inc.

Editorial Commentaries

Surrogate Measures of Arterial Stiffness

Do They Have Additive Predictive Value or Are They Only Surrogates of a Surrogate?

Stéphane Laurent

From the Department of Pharmacology and Inserm, Hôpital Européen Georges Pompidou, Paris, France.

Correspondence to Stéphane Laurent, Department of Pharmacology and Inserm EMI 0107, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France. E-mail stephane.laurent@egp.ap-hop-paris.fr

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Recent epidemiological studies have shown that arterial stiffness, measured through carotid-femoral pulse wave velocity (PWV), has an independent predictive value for cardiovascular (CV) events in several populations, including patients with uncomplicated essential hypertension^1,2 and type 2 diabetes.³ Arterial stiffness is thus an intermediate end point for CV events, predicting CV events independently of and beyond peripheral pulse pressure (PP).

Peripheral PP, central PP, and augmentation index, which provide additional information on wave reflection, are considered "surrogates" of arterial stiffness, because their pathophysiological meaning is clearly different.^4–6 Central PP and augmentation index are dependent on the speed of wave travel, the amplitude of reflected wave, the reflectance point, and the duration and pattern of ventricular ejection, especially with respect to change in heart rate and ventricular contractility. Aortic PWV, which is the speed of wave travel, represents intrinsically arterial stiffness, according to the Bramwell-Hill formula.^4–6

Two articles^7,8 in the present issue of Hypertension raise the issue of the predictive value of "surrogates of arterial stiffness" for CV events. Li et al⁷ studied the dynamic relationship between diastolic blood pressure (DBP0 and systolic blood pressure (SBP) in ambulatory blood pressure monitoring (ABPM) data throughout the day and calculated a novel index as 1– the regression slope of DBP on SBP. This index was named ambulatory arterial stiffness index (AASI) on the basis that "average distending BP varies during the day, and that the relation between DBP and SBP with this changing distending BP largely depends on the structural and functional characteristics of . . . [Full Text of this Article]

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